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So many words are bouncing around in my brain right now, but not many of them are making any sense at all. But I want to write this now, while it’s all still fresh in my mind, so that I can remember it later exactly how I remember it now.

Since my last post, Rio’s condition had steadily declined. In the evenings, she’d always just lay next to me on the couch, snoozing comfortably, but in the last few days, she’d been unable to really get comfortable. Her breathing had gotten a little more wheezy and shallow, and she’d cough after any level of exertion. But what really told me it was time was the fact that she rarely lit up anymore. I loved walking into a room and seeing her, because she’d always look like “HEY, IT’S YOU!!!!” The face that greeted me was always so happy, and in the last week I had rarely seen it. She perked up a bit when I mentioned going for a buh-bye or when I brought out the very favorite orange and blue rubber Chuck-it balls, but there was mostly no light.

I’d been thinking we were getting close… and I had spoken with her doctors about “the plan.” But part of me wanted so badly for her to keep fighting. I couldn’t really admit to myself just how much more tired and uncomfortable she was. I was still hoping she’d rally…

Wednesday, we had quite a bit of snow, and she was excited to go and catch snowballs, but after about 3 or 4, she was tired and didn’t want to play any more. I had to run over to her doctor’s house to pick up a box of Trilostane, and so she had a chance to take a look at Rio and see her in action. That day, she was almost crouching on her back leg as she hopped, because she was so tired. But the crazy girl kept going, kept running up to people and checking them for treats (there were a group of neighbor kids sledding in Dr. Rachel’s yard because she had the only good hill in the neighborhood, and Rio had to sniff them all). I finally put her back in the truck to rest while I finished talking with her doctor.

The next morning, Rio woke us before the crack of dawn coughing and vomiting, but then with a little coaxing, she ate breakfast, and by the afternoon, she seemed pretty normal again. She ate her lunch without any encouragement, and also her dinner. Even “second dinner” was eaten with some enthusiasm. But she wasn’t comfortable. She was restless, and having trouble finding a position that she could relax in. She moved from the couch to the floor, and then a few minutes later would ask to get back on the couch. This went on most of the evening. I chalked it up to a little too much exercise the day before and the fact that I hadn’t given her any of her meloxicam. (Her doctor and I had talked about moving to Rimadyl or other NSAID because it didn’t seem like the meloxicam was doing anything for her. But to do that, Rio needed to be off the meloxicam for 2-3 days.)

When Rio woke us Friday morning, again before daylight, coughing, gagging and vomiting, and refused her breakfast (this time no amount of coaxing could get her to touch it), I knew… If you could have seen her face… she just looked beaten, worn out, exhausted. I called her doctor and told her that Rio was finished fighting, and that it was time for her to rest. She sounded almost as heartbroken as I felt, and she said she’d come when she got off work.

I had wanted to take Rio out for one last adventure in her “Ride,” but the weather Friday was dreadful. It was literally pouring rain, and all the beautiful white snow was turning into sloppy, slushy, ankle-deep muck. But we could go for a ride in the Expedition, and so I loaded the girls in the back and drove around Kingston. While I was driving, I was trying to think of things that Rio loved that we could squeeze in on such a foul and stormy day. She loves ice cream, but the place that gave her the free ice cream this summer was closed for the winter season. The other place that we used to go was also closed until the end of January for some remodeling or something. I didn’t feel up to facing a bunch of people at the burger place either (no drive-through window), so I just made a quick stop at the grocery store, bought some hamburger and vanilla ice cream, and then we drove home.

We had wanted to bury her in my veggie garden because she loved to hang out with me there when I worked, however the ground was so saturated that the hole kept filling up with water, and there was no way I could put my girl into that cold brown water. I decided then to let the doctor take Rio’s body with her…

Shortly after we got home, a friend came over to say goodbye to Rio. Tosca and Zephyr were also very excited to see her, and they kept crowding between her and Rio. I finally gave them each a Chuck-it ball so that they would chill, and Allie could give Rio some loves. But Rio wanted her ball, too. She laid on the floor and tossed her ball to me and then to Allie, over and over, just as happy as could be. When Allie left, I made a special homemade “flying dutchman” on the grill, and while they were cooking, I fed the girls some ice cream.

And then Dr. Rachel arrived… Rio finished her burger and asked to get up on the couch, where she promptly went to sleep. We talked for a while, remembering funny stories about the Woo, about how she got her name, about the day I brought her home, about her unwavering ability to poop where ever she went, regardless of how many times she’d already gone that day. Dr. Rachel cried with us as she explained what she would be doing. And then she administered the sedative. Within just a few minutes, Rio visibly started relaxing. And that was the point at which I knew unequivocally that I was doing the right thing for her. Just seeing her so at peace, so restful after so much struggle and fight — that helped assuage my fears and doubts.

I kissed her sweet face and breathed in her Woo scent, trying to memorize the feel of her, the smell of her, telling her all the while how much I loved her, how sweet she was, how there would never be another dog like her, how lucky I was to have had her in my life. I told her now it was time to rest. She was very tired from her long fight, and now she she didn’t need to fight any more. She was so strong, such a warrior. And then we kissed her goodbye. And then we wrapped her up in a little brown blanket, and inside that bundle with her tired, battle-scarred body was my heart.

I slept badly last night, awakening frequently and spending hours staring out the window into the night. I watched the sun come up this morning with Zephyr spooned tightly against me, softly running my fingers through her silky curls and wishing, wishing that it was Rio’s softness and warmth just one more time….

Yesterday, we found out what was causing Zephyr’s (and to some degree, Tosca’s) incessant chewing and scratching… Yeah, my favorite: fleas. So, I dropped everything and bathed three dogs, washed several loads of bedding (both doggie and people) and vacuumed the entire house. The ironic part of the story is that I didn’t find a single flea on either Tosca or Zephyr, even though I looked and looked, both before, during and after their baths. When they both started scratching and chewing on themselves after we got home from Oregon, that was the first thing I did — look for fleas. Nothing. Absolutely not a single flea, no flea dirt, no sign, no nothing. Instead, I was sitting next to my sweet Rio on the couch and all of a sudden one crawled out of her fur at her amp incision scar and onto her naked belly, just as brazen as could be, followed by a complete mom freak-out. (About the only thing in the insect world that grosses me out more than fleas are ticks. Ugghh!!!) I don’t want to give Rio any unnecessary meds right now, so I will be rubbing her down daily with a few drops of eucalyptus oil in hopes that it will discourage any more nibbling by the stinking fleas. I did, however, douse the Monkey-doofuses post-bath with flea-killing chemicals (of which I am not proud)….

Speaking of the Woo, her fan club has been clamoring for an update on how she’s doing. Let’s just say, she’s battle-scarred and tired, but still fighting. I would love it if she makes it to her 1-year milestone (and then some), but I am fully aware that it might not happen. The swelling in her belly has gotten worse, and has moved down into the knee and ankle of her remaining back leg. Her mobility hasn’t been that great lately, either. She’s unsteady and frequently loses her balance and has to catch herself. I’m not sure if it’s due to the swelling in the leg, or if her floppy belly-skin is making her lose her balance. Regardless, she still has flashes of a younger, healthier Woo — especially with the snow of the last couple of days. She’s always loved snow, and my heart is happy to see her boing-boinging around in it. She got all silly after her bath yesterday, too, racing down the hall, tossing her head and snorting, grabbing her toys and flipping them into the air. And when I was giving Tosca a much-needed brushing, Rio was being “the Sheriff.” (She always polices certain activities such as brushing and toenail clipping, in case I need some protection.)

So, here’s hoping for a hoppy 1-year, but if we don’t make it that far, we’re gonna go out fighting…..

I have the need for a momentary lapse of control. And I’ll apologize in advance if I offend anyone, but I have to say this. I FUCKING HATE CANCER!!!! I HATE IT! I BEYOND-WORDS HATE IT!!! If cancer was a person, I would stab it in the eye, beat it to a bloody pulp, and then I’d do a little dance on its dead carcass.

We just got the news that my father-in-law’s prostate cancer has progressed to his skull, his spine, his shoulder blade, his ribs and both of his femurs. My mother-in-law isn’t handling the news very well — she lost her first husband to cancer (melanoma) too — she’s been having some heart issues, and the added stress isn’t helping.

I know we usually reserve our collective Tripawd mojo for our canine friends, but we could really use some for Rio’s gramma and grampa, too.

I mentioned in my last post, that we’d started feeding Rio 4 times a day as a means to compensate for slower processing in the ol’ puppy pooper. Between that and the (almost) cup of pumpkin a day, it seems to be helping — we’ve not had any more vomiting for several weeks, and she’s struggling less when she goes #2! That’s the good news… The bad news is…. I have created a monster. She’s decided that 4 meals a days isn’t nearly enough, and is lobbying hard for additional portions. She is eating us out of house and home. She doesn’t seem to be gaining any weight with all the additional meals which is a little troublesome, and I can definitely feel the “bad guy” in the V between her stomach and her hip, but looking at this from a purely “happy in the moment” point of view (which, I’ll admit is pretty rare), she is doing really good. Maybe even great. She’s been funny and playful and spirited, and yes, demanding, these last couple of weeks. And so, I say, if the appetite is good, and she wants to eat, I will feed her. I love this monster!!!

We just got home from today’s walk. It wasn’t a huge turn out, but this foundation has only been in existence since the inaugural walk of 2008, when man and dog walked from Austin to Boston to raise awareness for canine cancer. I think in a few years, it will gain momentum and attendance, because there was serious dedication from the folks that were there.

We arrived and checked in, got our t-shirts and a special light blue cancer survivor bandana for Rio and dark blue bandanas for the two Monkeybutts. We didn’t wear them, instead we opted for the pink Puppy Up bandanas that I had purchased a while back. Rio wore her Tripawds bandana, but then switched to her cape and tiara before the walk started. (A star always needs a wardrobe change!) And the humans wore our Tripawds Have a Ball! Team Tripawd shirts!

We got a chance to meet fellow Tripawd Kess and her Disc Dog posse, and they wowed us with their Frisbee tricks. Those dogs seriously catch some air!!!!! I expected to be impressed with her athleticism and speed, but I was bowled over. I KNEW she was a Tripawd, and yet I could easily forget that fact as I watched her move and leap. I have to say, I was so inspired by her that it brought tears to my eyes.

We played a little in the off-leash area with our friends Rayna and Yoshi, and then it was time to start the walk. We found out when we registered that our C0-Canine Marshall, Jetson’s mom was hospitalized for a really bad case of strep the night before the walk, so they weren’t able to attend. It was just Rio and her human cancer survivor counterpart, Shani. When we were swapping stories, it was ironic how nearly identical their paths were, except for the type of cancer. The walk coordinator introduced Shani and Rio, and then I shared Rio’s story. I did pretty good, only getting a little caught up in it towards the end, and I must have struck a chord with the crowd because I could see quite a few people dabbing at tears as I wrapped up. Then Shani told her story and cut the ribbon (yellow caution tape — I found that kinda funny), and we were off.

The trail ran through the park, following the curves of the White River. The air was crisp and the leaves were falling…. All in all, I doubt Mother Nature could have dialed up a better day. As we walked, several people caught up with us and we got to hear their dogs’ (past and present) cancer stories. We talked up Tripawds — our sign and banner got lots of conversations started.

And now we are home, with full bellies and I hear a lot of snoring… The girls had a very busy day. It’s not easy being so adored by so many… Here are a few more photos from today:

You can think you’re totally prepared for bad news, know exactly what the doctor is going to tell you, psych yourself up to hear the absolute worst news, and still be stunned to hear it. I think it’s because somewhere deep inside you’re still hoping that there will be a miracle. Somehow, in an amazing turn of events you become the lucky winner of the lottery, the amazed and grateful recipient of the ultimate jackpot!!!! And you smile and tearfully accept the prize, because you know there was never anyone so deserving of a miracle as your beautiful Rio.

But this was not my lucky day…. nor was it hers…. Today, the doctor told us that in the span of four weeks, while taking the Kinavet (our “last ditch effort” drug), the tumor in her lymph node has doubled in size. Soon it will be creating pressure on her colon. It could eventually become blocked, leading to a very rapid decline in her internal functions. The other possibility is that the mast cell could degranulate, causing something very similar to anaphylactic shock.

I’m trying so, SO very hard to focus on things like the fact that we’ve had four and a half years together since she was first diagnosed. My beautiful Rio and I have had some wonderful adventures together, and we still have time for a few more (if we hurry). Like the fact that she’s a fighter, and she hasn’t quit yet. Like the fact that she doesn’t know she’s sick, and she’s not in pain. But my heart is breaking because I know that soon, way too soon, the thing I love the most in life will be gone. And there’s not a damn thing I can do to change that. So, I’m gonna have myself a good cry and several glasses of wine, and tomorrow, I’m gonna see if I can’t find in myself a little more of Rio’s strength and courage….

I’m sitting here next to my girl, listening to her tummy gurgle it’s way through her breakfast, and I’m almost overwhelmed by how much I love this girl. She truly is my heart and soul.

Love this girl, I do, I do....

We had a visit with our dog-ter yesterday for bloodwork to make sure the meds are being tolerated on the inside. Other than a few extra medicinal naps (Gayle and Charon would be proud!!!), Rio is doing really well. Outwardly, we really haven’t seen any noticeable side effects from the Kinavet, so I’m hopeful that her bloodwork will indicate that she’s not having any negative effects from it (elevated protein in the urine, elevated liver enzymes, etc.). We have a follow-up ultrasound next week to see if it’s having any impact on the metastases. Fingers and paws crossed!!!!

Meanwhile, our city-girl friends, Rayna and Yoshi, are visiting again while their pawrents are visiting family in the Caymans. Good thing we have lots of room for doggies here at Camp Monroe!

First off, I wanted to let you all know how much the outpouring of support has meant to us. It’s been a rough couple of days (for me), and I really have been buoyed up by the “Tripawds Cheer Squad.” It’s one thing to have support from friends, but its another to have the support from people who’ve “been there” or are currently experiencing a lot of the same things we’re going through.

Secondly, I wanted to give a quick update… Rio’s cytology came back yesterday, and there were no big surprises. It was simply a confirmation of what we already suspected. After two nights of Google-mania, I have decided that we will give the Kinivet (masitinib) a try. We’ll monitor CBC and some protein-urine thing and recheck her ultrasound in 3-4 weeks. If at that time there doesn’t seem to be a significant reason to continue the meds, then we will stop. Fortunately, Rio has a wonderful dog-ter friend who has offered to get me the meds at cost, since they are newly approved and quite expensive.

Rio will also need to take benedryl and pepcid everyday from now on. There is a significant risk of degranulation, in which the Mast Cells basically explode and send histamines rampaging through the body. The risk at this stage is pretty high for stomach ulcers, bleeding, and anaphylactic shock, so the meds are precautionary. The benedryl makes her pretty sleepy, but I think the extra naps are good for her. (Gayle said so!)

When Rio started this journey at the beginning of this year, I told my husband I wanted to do a road trip with Rio. I’ve always wanted to see the Grand Canyon, and I want her to be there with me when I do. This summer has been pretty busy, and it’s been easy to make excuses for why it wasn’t possible to do this trip — who would take care of my clients, water my garden, where’s the gas money coming from, etc. I want you all to know, we are going! We are making the final plans and arrangements, but we are going. We’ll probably leave in a couple of weeks, stop and see some family and friends along the way, but Grand Canyon or Bust!!!! Those squirrels better look out!!!

I took Rio in this morning for her 4 month ultrasound recheck. If you’ve been following my occasionally very rambling posts, I will apologize in advance for their lengthy nature. This one may very likely take on a life of it’s own…. Enter at your own risk.

The outcome of a 4 hour wait at the vet’s is that her cancer has come back. Given my less than sunny nature, I can’t say that I wasn’t sort of anticipating the worse, especially given how AWFUL (no drama here, seriously) this entire year has been for our whole family — in fact, I spent several hours googling like crazy yesterday in order to prepare myself should the worst occur. But it still was a punch in the stomach when the vet tech took me into a room to hear the outcome of the results…

At Summit, most of the interaction between the client and the dog-ters and techs takes place in the waiting room. Symptoms are discussed, courses of treatment, surgical outcomes, etc. — quite fascinating to me, an unabashed people watcher — but if it’s really bad news, they take you into an exam room. They don’t tell you going in that its gonna be bad news, but trust me, I’ve spent enough hours here to know, watched enough comings and goings, seen the devastation on people’s faces. I know that if you go into the room, nothing good is going to come from it.

As usual, I digress (or maybe its just stalling tactics. If I don’t type it, then it isn’t true…. but, sadly, it is…..). Rio’s cancer has reemerged in the form of an enlarged lymph node and “suspicious” activity in her spleen. For Mast Cell cancer, this is “normal.” This is what it does. It moves to the spleen, the liver and then into the bone marrow as a form of basophilic leukemia. Some of the niggling little things I’ve been noticing lately — the persisant cough, her being out-of-breath following any sort of activity, the weird, lumpy bruise along her scar that a quarter-sized piece of skin peeled off of — these were starting send up red flags in my little pea-brain. Enough to send me running for my computer and re-reading a lot of my original research. Turns out, most of these “nothings” were actually symptoms that could be contributed to mild granulation — when the mast cells start breaking free of the tumors and moving about the body. And while they “could be,” I held on to the hope that they could also be symptoms of other less life-altering things. The cough, it could be allergies. It’s been a weird summer weather-wise. We planted a new garden. There could be more/new dusts, molds, plants, etc. The bruising could be a spider bite or other insect. I was hoping, hoping, hoping that I would be able to post this evening: Rio’s Ultrasound Results Were Clear!!!! But this has SOOOO not been our year….

I was still thinking positive and was actually quite cheerful when the vet tech came and said the doctor had my results and would go over them in the exam room, and then I faltered. I looked down at my little girl, and she looked up at me and said, “Come on, mom! They have cookies in that room!” And the whole time the dog-ter was giving me the run-down on options and treatments and time lines and quality of life, Rio kept shifting in the room to catch her eye. “Did you not see me sitting here?! Why are you NOT giving me cookies? Hellll-llo!!!” Even while the tears were falling, I kept laughing at her and her less-than-subtle begging! That’s my Woo… She never forgets a place that someone may have given her a cookie! It might have been years ago!!! And even if, in my opinion, it was less than optimal circumstances that put her in said place.

As a wrap-up, I could apologize for the lengthy nature of this blog post, however, let it not be said that I led you into it without a warning. I had a boss once who always got impatient with my project updates (not sure why…), and would always ask for the “net-net.” Well, here it is: The enlarged lymph node was aspirated, and we’ll get cytology back shortly (hopefully before the end of the week), but our oncologist is pretty certain that it is metastatic MCT. The “grainy” texture of her spleen has gotten worse, and her adrenal gland has a “mass.” Because the lymph node has changed since her last US (April), the change has either occurred while she was still on chemo, or has appeared post-chemo (in the last month). Neither of these situations is optimal.

My take on these findings: She’s always had a somewhat grainy appearance to her spleen, and has had cytology done every single time she’s undergone an ultrasound. I’m hoping that this is just more of the same. Her adrenal glands were different sized last time around as well, and although they usually see both of them enlarged with pituitary Cushings (and this is what we’re assuming Rio has), they weren’t overly concerned with their appearance last time ’round. I’m hoping that when they measure and compare, it won’t be too much more concerning this time. As for the lymph node, you can be certain that I have used my share of expletives (no children were present). Rest assured that we are still fighting!!! The options keep getting slimmer, but I’m not giving up on my girl! Mainly because that would constitute acknowledging that I am coward and life has beaten me, and I’m not quite there yet. However, I can use any and all support that you might feel inclined to shoot our way. I am certain that Rio will fight her way through all of this, as she has managed to do for the past 4+ years, however I am only human, and I am struggling to be as strong as my little rock(head).

Give your pups an extra large hug for us tonight!

Rio’s momma

PS: If any of have any firsthand knowledge about Kinivet (masitinib) and/or chlorambucil, please send me a PM.

So June and July were a whirlwind of activities — sadly, most of them not doggie related. We volunteer with the Kitsap Arts & Crafts Association, and our big festival/fundraiser was the final weekend in July. This was our second festival as volunteers, but the 52nd annual for the organization. We are struggling to keep it afloat with a tiny group of workers, and so it was complete madness for about 3 weeks!

I’ve been neglecting the Tripawds team somewhat lately, and I feel guilty about it — you’ve been so supportive to us, that I feel I owe the same support to others on the site. But as I log on with trepidation only to find the thing that I dread the most — that another of our dear friends has left us — it gets me thinking about the fragility of my own little friend a lot more than I’d really like. She’s no spring chicken to begin with, but this past 8 months has been really tough on her, and she’s visibly not the same dog she was as we ended 2010.

And while part of me tries desperately to enjoy every moment with my little friend, I can’t help but watch her like a hawk for any sign or symptom, with my heart catching in my throat if I think I might, maybe, perhaps see something. I’d rather not think about it at all, but I find myself running my hands over her, not just giving her lovies, but searching for the one thing that I really don’t want to find. So far, no signs of what I fear, but that doesn’t stop me from looking again in a little while. And unfortunately, the losses of our compatriots just serves to remind me a little too much that one day it will be my Rio. So although she’s enjoying life and she’s happy, this old dog (me) is having some trouble learning how to live in the now!

After several months of worrying (but not really wanting to know, if it was gonna be something bad), I finally broke down and had her cough checked out. We did a couple of chest films last week, and while they show some bronchial inflammation, there are no shadows, no evil lurking mets, no cancer. (I can’t remember who on Tripawds called them Boris and Natasha, but I LOVE that!) So phew! As we were at the vet for everypawdy’s annual check ups, we realized that Rio hasn’t had a “normal” vet appointment in so long, that she was 6 months late on her rabies vaccine! (If we lived in a less rural environment, and if Rio didn’t feel the need to kill all of the little critters that live in our yard, I probably would just forego any future vaccinations, because she really isn’t exposed to most of the “bugs” that they vaccinate against. But we do, and she does, so she got the shot.)

The monkeybutts got check-ups, too, and Tosca didn’t bite anyone! Yay! She also needed a rabies vaccine, although her’s was right on schedule. Zeffy got super tiny when the vet was examining her. She’s such a big baby at the doctor’s! It could be because when I first got her, she used to eat a lot of stuff she wasn’t s’posed to and we had to go to the vet a few times — for stomach pumping, for x-rays to check the intestines — experiences like that when you’re a tiny pup, and I guess you could be scarred (or just scared) for life. Plus, she’s not the bravest girl to start with….

We got to talking about how different all three girls are as patients, and how fortunate (if you can call it that) that it was Rio who had to have all the doctor visits. She is a model patient — she doesn’t bite, doesn’t squirm, lets them do everything they need to do without even so much as a “Hey, now!” when they take her temperature — the only trouble they ever have with her is that she doesn’t want to leave me, so they have to lure her into the back room with food.

Tosca, on the other hand, has a red flag in her chart because she tried to eat a vet tech’s hand, and has snapped at the doctor a few times. I have to really watch her closely, because if she’s not in the mood for it, somebody is going to lose a finger. And Zephyr, little Nervous Nell, goes completely limp or tries to hide under the furniture.

But, overall, everyone had a good check up — Tosca got lots of props for weighing in at a svelte 83 pounds. A few years ago, when I was in Ireland for a month, dad let T get as heavy as 103 lbs. Let’s just say, he got a bit of a WTF when I got home, even though, by then she was down to 98 lbs. She has been in the high 80’s to low 90’s for a while, and looks good at that weight, but she’s had a lot more energy and zip at this lower weight, so we think that we’ll keep her there. Zeffy was a healthy 74 lbs, down from her low 80’s weight, and Rio was her tiny self at 59 (pre-amp, she weighed in between 72-76 lbs). I think a lot of the weight loss that we’ve seen on all three of them can be directly related to their dietary changes over the last 8 months. So yay, me, for a healthier diet for the dogs — now it’s time to work on my own extra lbs!!!

Oh, and I have to say, it’s really nice to have a vet bill for once that didn’t give me a heart attack when I got it! 3 annual exams, 2 rabies vaccines, 2 chest x-rays (a little peace of mind), stool sample, urinalysis = $300!!!!! Granted, it’s still a lot of $$, but the x-rays alone probably would have been that much if I’d gone to Rio’s specialists for them. Which leads me to my next little quandary: to continue to see the specialists now that we’re past the chemo and have gotten the Cushings under control, or should I just get the abdominal ultrasounds, ACTH stimulation tests, etc. done by my regular vet? Cost-wise, it will be a lot less money, and since I doubt that I will put Rio through anymore chemo/radiation/etc. treatments — although I do reserve the right to change my mind should the need arise — do we really need the specialist’s expertise going forward? Rio is due for her abdominal ultrasound next week, and the last time I went, it was a 6 hour visit. That’s the other part of the equation — if I get the US done at a local clinic or with my regular vet’s traveling US tech (which may very well be the same one as what the specialty clinic uses), I get an actual appointment, whereas at Summit, they don’t schedule you — you’re supposed to drop the dog and pick up later. Since we drive 60+ miles to get there, it doesn’t make sense for me to drop Rio off and come back later to get her. What would I do? Where would I go? So I just bring the computer and hang out… Not exactly the best use of my time.

But the upside of having the oncology specialist, she’s treated Rio through all of this, and there’s a continuity and knowledge base to both her records and her care that is comforting. And her internal medicine specialist is in the same clinic as her oncologist, and they regularly consult with each other on her care (although that should have preempted what I like to call the Prednisone Debacle, but didn’t). So, is this worth the extra cost, the extra gas, drive time, TIME time, etc.? I don’t know…

Anyhow, to wrap up this brain dump, life is moving forward — often at a breakneck pace — and Rio is still kicking butt! Rio’s mom is a little worse for wear, though!